FORM
A
NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST
Jan 24, 2019
Amended Registration
Lobbyist Registration Fee:
{49-1480.01}

(If you are a salaried employee of your principal, you are a compensated lobbyist.)

PLEASE FILL IN ALL BLANKS

LOBBYIST {49-1480(1)}

635 S 14th Suite 315 

10506 S. 179th Street 

Lincoln 

NE 

68508 

Omaha 

NE 

68136 

(402) 327-1603 

 

jb@bnmlobby.com 

PRINCIPAL {49-1480(2)}

(402) 327-1603 

635 S 14th Suite 315 

 

Lincoln 

NE 

68508 

Government Relations 

AMOUNTS GIVEN
0.00  Percentage of salary  
IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} All matters of interest to the principal  
Description of industry, trade, profession, or interests and groups represented by the principal:
 
Names and addresses of principal's officers:

GIVE NAME and ADDRESS of any OFFICIAL in the Legislative or Executive Branch and of any members of any such official's staff or immediate family who is employed by you or by anyone acting on your behalf:

I certify that I am the Lobbyist listed above and that all information presented in this form is accurate to the best of my knowledge.